Objective To explore the application effect of case method combined with role play in clinical nursing teaching on hematologic diseases.Methods Totals of 100 nursing students from School of Nursing in Capital Medical University were selected, with the 50 enrolled in 2015 as the experimental group, and the other 50 in 2014 as the control group. Traditional teaching method was conducted to the control group, while students in the experimental group were taught with case method combined with role play. After the class, nursing students in the two groups took a theoretical examination on completion of the course and an evaluation on their writing on nursing plans, and were also evaluated by Active learning state (ALS).Results Compared with the control group, scores of students in the experimental group were higher in terms of theoretical examination and evaluation on their writing on nursing plans (P<0.05); total scores of ALS evaluation and scores in its individual items in the experimental group were higher than that in the control group (P<0.05). Conclusions In clinical nursing teaching on hematologic diseases, by circulating the teaching through combining case method and role play, a standardized handbook was formed, which can quickly and effectively improve the students' clinical nursing practice skills.

OBJECTIVETo analyze the results and influential factors of mobilization and harvesting of autologous peripheral blood stem cell in patients with multiple myeloma (MM).

METHODSRetrospective analysis of peripheral blood stem cell collection data [CD34⁺ cells collected, successful mobilization rate (CD34⁺ cells≥2×10⁶/kg body weight), good mobilization rate (CD34⁺ cells≥5×10⁶/kg body weight)] of 149 multiple myeloma patients who were treated with cyclophosphamide (CTX) or E-CHOP (etoposide+ CTX+epirubicin+vindesine+prednisone) chemotherapy combined with G-CSF mobilization from January 1998 to March 2014. The relevance between gender, age, subtype, DS staging, ISS staging, treatment before mobilization, disease status at mobilization, regiment of mobilizationand the collection results was analyzed.

RESULTSA total of 177 stem cell mobilizations were performed in 149 MM patients, the median CD34⁺ cells harvested were 3.20 (0.13-22.34)×10⁶/kg body weight (BW), successful mobilization rate and good mobilization rate were 74.5% and 27.5%, respectively. The single logistic regression analysis showed that gender, age （>60 ys vs ≤60 ys）, subtype, DS staging (III vs II+I), ISS staging (III vs II+I) and regiment of mobilization (E-CHOP+G-CSF vs ID-CTX+G-CSF) were not correlated with the cell collection or successful mobilization rate (P>0.05). However, successful collection rate of single harvest in old patients (age>60 ys) was lower (P<0.05), andthe good mobilization rate in patients at ISS stage III was lower (P<0.05). The collection results of patients with fewer cycles of treatment (treatment before mobilization ≤6 cycles) and optimal disease status (disease status at mobilization ≥partial remission) were much better. Analysis of logistic factors revealed that treatment efficacy before mobilization affected success rate of collection (P=0.006). Risk of collection failure in patients who received more than 6 cycles of treatment before mobilization was high (OR 3.57, 95% CI 1.45-8.78).

CONCLUSIONGender, age, subtype, DS staging, ISS staging and mobilization regimen did not influence MM patients peripheral blood stem cell collection; but old patients may need twice mobilizations to collect sufficiently. Few cycles of treatment and stable disease status before mobilization is favorable to the mobilization and collection of peripheral blood stem cells.

Antigens, CD34 ; Cyclophosphamide ; Filgrastim ; Granulocyte Colony-Stimulating Factor ; Hematopoietic Stem Cell Mobilization ; Hematopoietic Stem Cells ; Humans ; Multiple Myeloma ; Retrospective Studies ; Treatment Outcome